Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, SUS Malmö, Lund University, Malmö, Sweden.
Acta Orthop. 2010 Aug;81(4):453-9. doi: 10.3109/17453674.2010.492762.
Although the incidence of hip fracture during the past 50 years has increased, a break in this trend has been reported in the last decade. Whether this change is attributable to changes in bone mineral density (BMD) or whether it varies between urban and rural regions is unknown.
We evaluated changes in annual hip fracture incidence in women aged > or = 50 years in one urban population (n = 51,757) and one rural population (n = 26,446) from 1987 to 2002. We also examined secular differences in BMD (mg/cm(2)), evaluated by single-photon absorptiometry at the distal radius, prevalence of osteoporosis, and several other risk factors for hip fracture in one population-based sample of urban women and one sample of rural women aged 50-80 years at two time points: 1988/89 (n = 257 and n = 180, respectively) and 1998/99 (n = 171 and n = 118, respectively).
No statistically significant changes were evident in annual age-adjusted hip fracture incidence per 10(4) when analyzing all women (-0.01 per year (95% CI: -0.37, 0.35)), rural women (-0.38 per year (-1.05, 0.28)), or urban women (0.19 per year (-0.28, 0.67)). BMD (expressed as T-score) was similar in 1988/99 and 1998/99 when analyzing all women (-0.09 (-0.26, 0.09)), urban women (-0.04 (-0.27, 0.19)), or rural women (-0.15 (-0.42, 0.13)) women.
Since no changes in age-adjusted hip fracture incidence and no differences in BMD were found during the study period, changes evident in the other risk factors for hip fracture that we investigated (such as gait velocity and balance) are either of minor importance or are counteracted by changes in other risk factors.
尽管过去 50 年来髋部骨折的发病率有所上升，但最近十年报告称这一趋势有所中断。这种变化是否归因于骨密度（BMD）的变化，或者城乡地区之间是否存在差异尚不清楚。
我们评估了 1987 年至 2002 年间一个城市人群（n=51757）和一个农村人群（n=26446）中年龄≥50 岁的女性每年髋部骨折发病率的变化。我们还通过单光子吸收法评估了桡骨远端的 BMD（mg/cm(2)）的年代差异，检测了一个基于人群的城市女性样本和一个农村女性样本（年龄 50-80 岁）在两个时间点的骨质疏松症患病率和其他几个髋部骨折风险因素：1988/89 年（n=257 和 n=180）和 1998/99 年（n=171 和 n=118）。
在分析所有女性（每年每 10(4)个年龄调整的髋部骨折发生率减少 0.01（95%CI：-0.37，0.35））、农村女性（每年减少 0.38（-1.05，0.28））或城市女性（每年增加 0.19（-0.28，0.67））时，髋部骨折的年发病率无统计学意义。在分析所有女性（T 评分）时，1988/89 年和 1998/99 年的 BMD（-0.09（-0.26，0.09））、城市女性（-0.04（-0.27，0.19））或农村女性（-0.15（-0.42，0.13））的 BMD 相似。
由于研究期间髋部骨折的年龄调整发病率没有变化，我们研究的髋部骨折其他危险因素（如步态速度和平衡）也没有变化，或者被其他危险因素的变化所抵消。
